Age-Related Counseling Requirements for Women with Epilepsy

PURPOSE: Women with epilepsy (WWE) have varying concerns at different ages and require relevant counseling and management. We conducted a retrospective chart review of WWE seen at the specialized women's epilepsy clinic at Westchester Medical Center (WMC) from May 2024 to June 2025. FINDINGS: We included patients 18 or older assigned female at birth referred for epilepsy evaluation and management. There were 117 patients who were subdivided into the age groups of 18-30, 31-44, and above 45 years old. 65.9% of patients received care related to the management of seizures or epilepsy, whereas 23% were found to have seizure mimics such as syncope, tremors, migraines, or transient ischemic attacks, and 11% were identified as functional seizures or functional neurological disorder. Our results show that 22% of patients with epilepsy on antiseizure medications (ASMs) had never received contraception counseling, 48% were unaware of fetal malformation risks from ASMs and the benefit of folic acid supplementation, and 71% had not been counseled on bone health. CONCLUSIONS: Women seen in a specialized women's epilepsy clinic at WMC demonstrated distinct age-related concerns. Younger patients focused on reproductive health, whereas older patients prioritized comorbidities and seizure mimics. Unlike prior data, patients aged 31-44 and 45 and above had greater counseling needs than the 18-30 age group transitioning from pediatric care. These findings support the need for age-specific epilepsy counseling and targeted counseling to improve patient compliance. This study underscores the need for a specialized epilepsy clinic in addressing both medical and psychosocial aspects of care for WWE.